Does anyone else get a knife like pain inside when sitting? It's driving me nut's and lying down all day is not an option. Is it the spasm's that cause the sharp pain?

I do for sure...especially when my fissure was very active and new. I would say yes, it is the spasm, at least from my experience.

Any irritation to the area (ex: bm or even sitting) can cause pain at the fissure site, which can instigate spasms, and then the spasms in turn put pressure on the fissure - this is where I would get the pain you describe.

-GG

Thank you. Its so miserable. This is the 5th fissure I have had over 30 years. Sitting and driving is almost impossible

Have you had LIS? if the resting pressure of the internal anal sphincter is higher than normal, you may be prone to recurrent fissures...LIS may help this once and for all for you. That's a long time to be dealing with these stupid things - I'm so sorry.

I had surgery for the first one when I was in my 20's. Didn't have any problems for about 15 years, then got another one which resolved with proctosedyl. I cannot take the GTN cream as have very low BP and I blacked out with it! Was given a dilator and more proctosedyl. This time though, the dilator seems to have made it much worse. No blood, just the knife like pain after BM and when sitting. Reluctant to go down the surgery route again. It truly is unbelievable how much pain a fissure can cause

Ah I see... that's tough. Although 15 years no fissure post surgery isn't bad!!

How about Botox? Additionally, I saw a pelvic floor physiotherapist. She wasn't able to help too too much because my pain level is so high, but she did help me to relax all my other pelvic floor muscles besides the sphincter, and confirmed that my resting pressure was very high. And when things were really bad, she would just do full body massage, and at the very least it helped take my mind off the pain and help me relax. It might be worth looking into.

I have the same.... all my pelvic floor muscles go into spasm. Aches all over. I have really nasty trigger points. I'm a chiropractor and try to do self treatment which helps a little. Amazing how all the other muscles in the area get drawn in to the picture. I don't think that surgeons like doing LIS a second time. Botox scares me. I realise it has helped many people but I can't get away from it being a highly poisonous toxin. Still if there is nothing else I can see me going for it.

Ah ok!

Well I'm kind of with you on Botox (I'm a biologist...I know too much lol). But I have been told that IF you're resting pressure of the internal anal sphincter is high, then a second LIS is warranted. If it is not high, then the LIS would likely not help anyways. Very often surgeons are conservative to start, and a second LIS is required to fully achieve some relaxation of the sphincter.

That's what I've been told - I would consult with a CRS or two if you can!! Awful that you're going through this again, so sorry

Hello GG, just checking in to see how your doing and if you have a LIS date? Wishing you the best. It is about a month and a half since Botox, and the fissure area pain is much better. Primarily I have the muscles surrounding and higher up to the tailbone and surrounding muscles discomfort, sometimes intense but improving a bit. Thought I would share that even though a fissure is healed it can take 3 to 6 months to fully heal, and until then these symptoms will be ongoing with maybe 25% improvement per month> ?Its a weird pushing out feeling, I suppose that's still a form of levator spasm, which Dr said can be caused by a fissure and the chronic tension.

Most of the posts that have similar posts have not come back to report their success....shucks... I love reading those , I will be sure to post that report, as I am sure you will as well. Reading alot about the mind body connection seems to make sense, at least a reasonable approach. My daughters wedding is the first week of August so I have time to be back to good as new!! Can't wait. keep me posted...

correction..2 1/2 months since Botox...a month and a half since I was told healed...